Department of Cardiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Pediatric Congenital Heart Disease Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Am J Hypertens. 2019 Apr 22;32(5):452-459. doi: 10.1093/ajh/hpz016.
BACKGROUND: Dapagliflozin (DAPA) is an inhibitor of sodium-glucose cotransporter 2 prescribed for type 2 diabetes mellitus. DAPA plays a protective role against cardiovascular diseases. Nevertheless, the effect and mechanism of DAPA on pressure-overload-induced cardiac remodeling has not been determined. METHODS: We used a transverse aortic constriction (TAC) induced cardiac remodeling model to evaluate the effect of DAPA. Twenty-four C57BL/6J mice were divided into 3 groups: Sham, TAC, and TAC + DAPA groups (n = 8, each). DAPA was administered by gavage (1.0 mg/kg/day) for 4 weeks in the TAC + DAPA group, and then the myocardial hypertrophy, cardiac systolic function, myocardial fibrosis, and cardiomyocyte apoptosis were evaluated. RESULTS: Mice in TAC group showed increased heart weight/body weight, left ventricular (LV) diameter, LV posterior wall thickness, and decreased LV ejection fraction and LV fractional shortening. The collagen volume fraction and perivascular collagen area/luminal area ratio were significantly greater in the TAC group; the TUNEL-positive cell number and PARP level were also increased. We found that DAPA treatment reduced myocardial hypertrophy, myocardial interstitial and perivascular fibrosis, and cardiomyocyte apoptosis. Furthermore, DAPA administration inhibited phosphorylation of P38 and JNK in TAC group. In addition, the inhibited phosphorylation of FoxO1 in the TAC mice was upregulated by DAPA administration. CONCLUSION: DAPA administration had a cardioprotective effect by improving cardiac systolic function, inhibiting myocardial fibrosis and cardiomyocyte apoptosis in a TAC mouse model, indicating that it could serve as a new therapy to prevent pathological cardiac remodeling in nondiabetics.
背景:达格列净(DAPA)是一种钠-葡萄糖共转运蛋白 2 抑制剂,用于治疗 2 型糖尿病。DAPA 对心血管疾病具有保护作用。然而,DAPA 对压力超负荷引起的心脏重构的作用和机制尚未确定。
方法:我们使用横断主动脉缩窄(TAC)诱导的心脏重构模型来评估 DAPA 的作用。将 24 只 C57BL/6J 小鼠分为 3 组:假手术组(Sham)、TAC 组和 TAC+DAPA 组(n=8,每组)。TAC+DAPA 组通过灌胃给予 DAPA(1.0mg/kg/天)4 周,然后评估心肌肥厚、心脏收缩功能、心肌纤维化和心肌细胞凋亡。
结果:TAC 组小鼠的心脏重量/体重、左心室(LV)直径、LV 后壁厚度增加,LV 射血分数和 LV 缩短分数降低。TAC 组的胶原容积分数和血管周围胶原面积/管腔面积比显著增加;TUNEL 阳性细胞数和 PARP 水平也增加。我们发现 DAPA 治疗可减轻心肌肥厚、心肌间质和血管周围纤维化以及心肌细胞凋亡。此外,DAPA 给药抑制了 TAC 组中 P38 和 JNK 的磷酸化。此外,DAPA 给药上调了 TAC 小鼠中 FoxO1 的磷酸化抑制。
结论:DAPA 给药可改善 TAC 小鼠模型的心脏收缩功能,抑制心肌纤维化和心肌细胞凋亡,具有心脏保护作用,表明它可作为一种新的治疗方法,预防非糖尿病患者的病理性心脏重构。
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